This Angel is pissed off. I'm Nurse Anne and I work on large general medical ward in the NHS. These are the wards with the most issues surrounding nursing care. The problems are mostly down to intentional understaffing by hospital chiefs that result in a lack of real nurses on the wards.
"The martyr sacrifices themselves entirely in vain. Or rather not in vain, for they merely make the selfish more selfish, the lazy more lazy and the narrow more narrow"-Florence Nightengale

Sunday, 27 June 2010

A Very Angry Patient

And her anger is justified. Justified to the tenth power.

Many times on this blog I have posted about nursing cadets and apprentices. These are the untrained 16 year old kids without a shred of nursing knowledge that the hospitals are hiring these days instead of real Nurses. The real Nurses (the few of us that there are) are just running between too many patients because the cadets can do so little.

I have worked with a couple of cadets who are diamonds in a sea of shit. There is no knowledge there but they were mature for their ages, hellbent on becoming good nurses someday,and willing to learn.

The rest of them suck. And they don't care either. They don't want to become Nurses. They just want a few quid to go out with and the hospital pays them slightly more than McDonald's. The immaturity and attitude problems are unbelievable. They are not vetted properly. How I miss my older, experienced health care assistants who are mostly gone. How I miss all the experienced Real Nurses who have left and not been replaced by other Real Nurses. I could cry when I come onto shift with no one but inexperienced cadets who cannot do anything to "help". The public assumes that these kids are some kind of Nurse or something as they are wearing uniforms and handing out bedpans. Therefore the patients and visitors are not realising the true extant of the staffing problems.

One of these cadets really fucked off a patient and her husband. Let me tell you what happened. I wasn't on my usual ward but had been moved to another for the day as they had no staff. Neither did my ward but I was still taken from it for the day. *Details all changed as I comply with Hippa and always maintain confidentiality.

Older lady with congestive cardiac failure. Very swollen, very little output. Given massive amounts of Furosemide, a diuretic which makes a person wee for England. This drug helps their bodies get rid of all that excess fluid that is making it hard to breathe. Google congestive cardiac failure, fluid overload, and furosemide if you are confused. I don't want to explain it all on this post. We also keep these patients on fluid restrictions. Therefore they are not taking that much oral fluid.

The third time this nice lady rang her call bell for a commode to pass urine she expressed to me her worries that she was "being a pain, a right nuisance".

I reassured her that she most certainly was not a pain. I told her that it was an excellent thing that she was passing so much urine because it shows us that the drugs are working and her condition is improving. She had other medical problems in addition to failure that was making her short of breath. I also reassured her that she did right in ringing for a commode rather than trying to walk all the way down the hall to the toilets. I reinforced the need for the fluid restriction to keep her from any further overload. I was happy with the patient. She seemed happy with me. All good.

Lovely lady, no trouble at all. Not a bit.

I had 20 other patients and was caring for them when this nice lady rang again for a commode. Vikki Pollard, a 17 year old cadet (NOT A NURSE or even a trainee nurse) who was busted recently for 20 smoke breaks a shift answered her bell.

Vikki was the only other person I was working with for this group of 20 patients. Vikki did not want to be at work. She has no interest in nursing and never plans on becoming a nurse. She wants a paycheck. It was very easy for her to get a job at the hospital since the trust has decided to hire people like Vikki rather than actual Nurses. Vikki has no knowledge of CCF, diuretic medications, respiratory problems, congestive cardiac failure etc etc.

So Vikki answered this lady's call bell about 30 minutes after I was out of the room and said this to the patient:

"OMG I can't believe you are ringing again. Why can't you be bothered to get up and walk to the bathroom. Stop drinking so much if it makes you wee like that".

Vikki of course had sat through handover with me that morning. She heard that the patient was a CCFer on diuretics etc etc. That fluids were a bit restricted etc etc. But Vikki sleeps through handover and none of that information registers with her. There is so much of this information about all the patients that I am caring for that it is physically impossible for me to stay on top of Vikki's whereabouts and explain it all to her.

The next time I went into the patient's room she was quiet and didn't say very much. When her husband came into visit she unloaded to him. He cornered me and let loose wanting to know why some "young nurse" spoke to his wife that way 30 minutes after another nurse told her that passing urine so much and ringing for a commode was fine.

"You people don't know what you are doing"

"That young nurse as an abomination and should be struck off, so much for educating nurses at Uni"

"My wife is very hurt". (feelings)

Was he wrong? Only in the fact that he thought Vikki was a nurse and believed she could be struck off. She isn't actually a nurse so she isn't registered with any professional body to be struck off from. She certainly hasn't had nurse training or ever attended university. It takes an education to understand the situation of these patients and be truly compassionate. I will most likely take the heat for this as I am the one with the nurse registration. The trust doesn't want to lose the cheap untrained labour. But they want to lose qualified nurses.

What could I say to this man? Other than apologising and agreeing with him what could I say to make it better? I can't deflect all responsibility onto Vikki Pollard because I am the patient's nurse. I did try to explain to the husband that Vikki was an assistant and not a nurse and therefore she did not understand the situation. But there is no excuse for the way she spoke to the patient and I agreed with him on that. I spoke to the chief nurse about it all. Nothing has been done. They are still reducing the number of qualified nurses at ward level (both old and new trained) in favour of these young kids and novices. Both the older trained and new uni nurses are on their knees being so few in number and they cannot find jobs on the wards.

What to do what to do.

This is where the argument that nurses are "uncaring as a result of being university educated " Falls apart. I studied so much pathophysiology and pharmacology in nursing school that I understood this patient's situation completely (from a nursing, if not a medical perspective). Had this lady rang her bell 50 times an hour to pee my knowledge would have allowed me understand why and demonstrate compassion as a result of that understanding. Poorly educated and poorly trained carers are more likely to lose their rag with these patients as well as very demanding patients because of their lack of knowledge.

But thanks to the likes of Melanie Phillips, Frank Field, Iain Dale, and Minette Marin, the hospitals will continue to get away with poorly educated carers in the place of nurses. And not only that, but we will have poorly educated old fashioned trained nurses who cannot deal with the demands of modern patient acuity. * Edit They would be able to handle it if they had decades of experience under their belts. But new recruits to nursing will not have that, or the support that the nurse's who trained in the 70's had. This is due to poor staffing. If some of these self professed nursing and nurse education experts (who have never studied nursing , let alone understand what a nurse actually is) get their way and remove nurse training from university the hospitals will be even more full of Vikki Pollards as both qualified and unqualified staff in the future.

52 comments:

Liz
said...

Brilliant post Anne until (Ahhh!OMG, there she goes again)... "And not only that, we will have poorly educated nurses old fashioned trained nurse who cannot deal with the demands of modern patient acuity."

You can handle it if you trained back in the old days, are still working, and up to date. You have more experience. It probably makes you much more knowledgable than I. I am sure it does actually.

But if you trained a young modern kid under those old fashioned conditions and just dumped them out on a modern ward all hell would break lose.

This is what I always said. The old training was FABULOUS for it's times. And the old fashioned nurses who are still up to their eyeballs in frontline direct care are FABULOUS. But that is as far as it goes. From here on in the youngins need to do the degree. They don't have the matrons and sisters and other qualifieds around that you did and there is more acuity.

I should say that the youngins won't have the support when they are on duty of matrons, and other qualified staff. They need the kind of critical thinking skills that can only be obtained from higher education.

By the way did I ever tell you that I choose to do my training at one of the oldest, most respected diploma hopsital based nursing schools in North America?

We were their last set of diploma grads and for our class we had to do the university stuff on top of the old fashioned diploma program that our grandmother's did.

So I might do a practical placement on a ward for 8 hours and then have to go to microbiology and pharmocology classes that same evening over at the university that was partnered with the hospital nursing school.

Then the next day I might have an 8 hour lecture at the hospital's school of nursing diploma program. Their program hadn't changed much since the 1940's. Then that evening it was chemistry 5 miles away at the university. Next day it was 8 hours of placement on the wards. Did this shit year around for 3 years+ and qualified with an old fashioned diploma from a WW2 era school as well as a degree from a well respected university. Simultaneously.

I am old fashioned trained. Ha ha ha.

We had to do all the university level anatomy, pathophysio,maths pharmo, micro, chemistry etc in additon to doing the old fashioned diploma. We did it at the same time and qualified with a diploma and a degree. The hospital school of nursing stayed in contact with the university and if we scored lower than a B in class at the University we were flunked out of the program.

I am talking to myself here but at graduation we had to wear old fashioned white dresses, nurse caps, and white tights.

The housemother was strict. No make up and she inspected our rooms. But since we were technically students at the big university 5 miles away also we went there to get pissed and act out. As long as the school of nursing didn't find out we were okay. Early 1990's...just saying.

We have some nurses on my ward who trained in the 70's. They are beyond fabulous. Very intelligent people who have continued to update their knowledge via university, self study etc. Can't hold a candle to them. I think in their day it was a choice between Nurse, teacher, and flight attendent for females.

Just to say how much I thoroughly enjoy reading your blog, (if enjoy is the right word) as I find it incredibly informative, but also very frightening. My frail elderly mum is due to go into hospital for a routine operation - her first time in - and after reading your blog I am absolutely terrified for her. I have already had some pretty bad experiences with hospital care, though have always felt the staff so the very best they can considering the circumstances.

Love it. As someone who trained in the late seventies/early eighties you are right about the career options ;0)On a more serious note, my Trust has started thinking about using "cadets" as they are cheaper than HCAs. Although critical care and ED will escape, everywhere else will not. I hope that your experiences with cadets will not be typical. Although I doubt it.

We have almost no HCA's dino. We have "cadets". One two amazing. smart, and mature ones and the rest drunken 17 year old shit.

Things are getting worst at much trust Dino. Can't say much but let's just say my unit is changing. We are about to become way more acute. With the same staffing numbers. I think they said we can have .5 of a cadet (?) and then we will have "adequate staffing".

Thanks for your message anonymous. Don't worry. It's highly unlikely you are at my trust. We have a new member of staff at the hospital (not on my ward, not nursing). Was talking to her in the car park and she cannot believe how bad it is compared to the trust she was at before.

How true. I long ago stopped watching UK hospital dramas as they just made me rant. Used to like some of the US stuff (ER, Scrubs, Nurse Jackie) but recently caught an episode of Greys Anatomy. OMG. No wonder the great British public think all we do is sleep with doctors and bitch at the nurses station...in this show the doctors even handed out bedpans for Gods sake. I know its not supposed to be real but Joe Public thinks it is...fed on a diet of Big Brother and Jerry Springer type shows he/she believes that tv tells the truth. No really. Just yesterday I had a relative on the admissions unit demand that her mum (who needed a cannula) be seen by the consultant and not the "pleb" as she called the SpR. Its "my right" she stated and quoted the patients charter at me, not wanting to be judgemental but the world of Vicky Pollard was staring straight at me. I have given up trying to explain that its not how the system works. Nevermind that the medical consultant on-call probably last put in a cannula in the late 1990s. As always I just smiled sweetly and directed her to PALS.

The public assumes they know what a doctor is. They assume they know what a nurse is.

They don't. What they don't realise is that most of their "knowledge" comes from childrens' books that show Dr. Smith doing all the treatment while Nurse Susie hands the patient a teddy bear.

Their "knowledge" comes from Grey's anatomy, House and the daily mail. They don't even realise that their minds are warped or that their opinions have been molded by inaccurate media portayals.

I saw a comment on a blog that went like this "why does a nurse need to go to university when her entire job revolves around the physical hygeine needs of the patient". This guy was serious. You just cannot believe the stupidity.

I had a patient come from a surgical ward with fast running IV fluids. He was short of breath, neck the size of a tree trunk, no urine output, no diuretics ordered. Fucking surgical ward over did it with the fluids and then sent him to us ? PE. Yeah right. Maybe, but he was obviosuly in failure. As I was waiting for the doc to call me back I stopped the fluids, put the 02 on, catheterized him, got the furosemide ready in case they ordered it. et etc. Doctors are not usually just there in an instant. They don't hang out on the wards in real life.

As I was stopping patient's drip his daughter put her hand on my arm and said in a very nasty tone "what will the doctor think of your messing about and stopping the fluids, he might get dehydrated you know".

Actually bitch the doctor will have a fit if I leave all this stuff untouched for two hours until he gets here. These are nursing duties and the kinds of things that the doctors expect just to get done in this situation without him being there or having to tell me. As a matter of fact, if your dad dies (and he will if you don't get your hand off my arm and let me stop those fluids that are killing him) I will get blamed for not stopping those fluids that are overloading him and sending him into heart failure. This stuff is basic nursing, not doctoring. I don't mind questions but when they are arrogant and nasty I desire to respond in kind.

But on television these people see the doctors doing all aspects of care while the nurse merely answers the phone and "helps" the doctor. They think that is real. Their minds are warped.

I decided to put a patient with a grade 2 pressure ulcer on an airmattress. "What will the doctor think about that, isn't it his decision" said the patient's son.

Pressure area care is the last thing doctors ever ever ever want to hear about and if I EVER rang a busy doctor to ask what I should be doing about pressure area care he would scream at me and report me for dumping nursing duties on him.

But the public thinks that the doctors are the top of the food chain, in charge of everything. They are merely in charge of diagnosing illness, interpreting test results and prescribing a plan of treatment. That is different from being in charge of the whole 9 yards.

Once a care assistant forgot to leave a patient a glass for his water and the patient demanded to speak to the doctor in charge about this lapse in care.

LOL LOL LOL. Really, the doctor is more concerned about diagnosing and treating your illness. Now let me get you that water glass and remind the HCA not to miss your bed.

The public assumes they know what a doctor is. They assume they know what a nurse is.

They don't. What they don't realise is that most of their "knowledge" comes from childrens' books that show Dr. Smith doing all the treatment while Nurse Susie hands the patient a teddy bear.

Their "knowledge" comes from Grey's anatomy, House and the daily mail. They don't even realise that their minds are warped or that their opinions have been molded by inaccurate media portayals.

I saw a comment on a blog that went like this "why does a nurse need to go to university when her entire job revolves around the physical hygeine needs of the patient". This guy was serious. You just cannot believe the stupidity.

I had a patient come from a surgical ward with fast running IV fluids. He was short of breath, neck the size of a tree trunk, no urine output, no diuretics ordered. Fucking surgical ward over did it with the fluids and then sent him to us ? PE. Yeah right. Maybe, but he was obviosuly in failure. As I was waiting for the doc to call me back I stopped the fluids, put the 02 on, catheterized him, got the furosemide ready in case they ordered it. et etc. Doctors are not usually just there in an instant. They don't hang out on the wards in real life.

As I was stopping patient's drip his daughter put her hand on my arm and said in a very nasty tone "what will the doctor think of your messing about and stopping the fluids, he might get dehydrated you know".

Actually bitch the doctor will have a fit if I leave all this stuff untouched for two hours until he gets here. These are nursing duties and the kinds of things that the doctors expect just to get done in this situation without him being there or having to tell me. As a matter of fact, if your dad dies (and he will if you don't get your hand off my arm and let me stop those fluids that are killing him) I will get blamed for not stopping those fluids that are overloading him and sending him into heart failure. This stuff is basic nursing, not doctoring. I don't mind questions but when they are arrogant and nasty I desire to respond in kind.

But on television these people see the doctors doing all aspects of care while the nurse merely answers the phone and "helps" the doctor. They think that is real. Their minds are warped.

I decided to put a patient with a grade 2 pressure ulcer on an airmattress. "What will the doctor think about that, isn't it his decision" said the patient's son.

Pressure area care is the last thing doctors ever ever ever want to hear about and if I EVER rang a busy doctor to ask what I should be doing about pressure area care he would scream at me and report me for dumping nursing duties on him.

But the public thinks that the doctors are the top of the food chain, in charge of everything. They are merely in charge of diagnosing illness, interpreting test results and prescribing a plan of treatment. That is different from being in charge of the whole 9 yards.

Once a care assistant forgot to leave a patient a glass for his water and the patient demanded to speak to the doctor in charge about this lapse in care.

LOL LOL LOL. Really, the doctor is more concerned about diagnosing and treating your illness. Now let me get you that water glass and remind the HCA not to miss your bed.

The public assumes they know what a doctor is. They assume they know what a nurse is.

They don't. What they don't realise is that most of their "knowledge" comes from childrens' books that show Dr. Smith doing all the treatment while Nurse Susie hands the patient a teddy bear.

Their "knowledge" comes from Grey's anatomy, House and the daily mail. They don't even realise that their minds are warped or that their opinions have been molded by inaccurate media portayals.

I saw a comment on a blog that went like this "why does a nurse need to go to university when her entire job revolves around the physical hygeine needs of the patient". This guy was serious. You just cannot believe the stupidity.

I had a patient come from a surgical ward with fast running IV fluids. He was short of breath, neck the size of a tree trunk, no urine output, no diuretics ordered. Fucking surgical ward over did it with the fluids and then sent him to us ? PE. Yeah right. Maybe, but he was obviosuly in failure. As I was waiting for the doc to call me back I stopped the fluids, put the 02 on, catheterized him, got the furosemide ready in case they ordered it. et etc. Doctors are not usually just there in an instant. They don't hang out on the wards in real life.

As I was stopping patient's drip his daughter put her hand on my arm and said in a very nasty tone "what will the doctor think of your messing about and stopping the fluids, he might get dehydrated you know".

Actually bitch the doctor will have a fit if I leave all this stuff untouched for two hours until he gets here. These are nursing duties and the kinds of things that the doctors expect just to get done in this situation without him being there or having to tell me. As a matter of fact, if your dad dies (and he will if you don't get your hand off my arm and let me stop those fluids that are killing him) I will get blamed for not stopping those fluids that are overloading him and sending him into heart failure. This stuff is basic nursing, not doctoring. I don't mind questions but when they are arrogant and nasty I desire to respond in kind.

But on television these people see the doctors doing all aspects of care while the nurse merely answers the phone and "helps" the doctor. They think that is real. Their minds are warped.

I decided to put a patient with a grade 2 pressure ulcer on an airmattress. "What will the doctor think about that, isn't it his decision" said the patient's son.

Pressure area care is the last thing doctors ever ever ever want to hear about and if I EVER rang a busy doctor to ask what I should be doing about pressure area care he would scream at me and report me for dumping nursing duties on him.

But the public thinks that the doctors are the top of the food chain, in charge of everything. They are merely in charge of diagnosing illness, interpreting test results and prescribing a plan of treatment. That is different from being in charge of the whole 9 yards.

Once a care assistant forgot to leave a patient a glass for his water and the patient demanded to speak to the doctor in charge about this lapse in care.

LOL LOL LOL. Really, the doctor is more concerned about diagnosing and treating your illness. Now let me get you that water glass and remind the HCA not to miss your bed.

The public assumes they know what a doctor is. They assume they know what a nurse is.

They don't. What they don't realise is that most of their "knowledge" comes from childrens' books that show Dr. Smith doing all the treatment while Nurse Susie hands the patient a teddy bear.

Their "knowledge" comes from Grey's anatomy, House and the daily mail. They don't even realise that their minds are warped or that their opinions have been molded by inaccurate media portayals.

I saw a comment on a blog that went like this "why does a nurse need to go to university when her entire job revolves around the physical hygeine needs of the patient". This guy was serious. You just cannot believe the stupidity.

I had a patient come from a surgical ward with fast running IV fluids. He was short of breath, neck the size of a tree trunk, no urine output, no diuretics ordered. Fucking surgical ward over did it with the fluids and then sent him to us ? PE. Yeah right. Maybe, but he was obviosuly in failure. As I was waiting for the doc to call me back I stopped the fluids, put the 02 on, catheterized him, got the furosemide ready in case they ordered it. et etc. Doctors are not usually just there in an instant. They don't hang out on the wards in real life.

As I was stopping patient's drip his daughter put her hand on my arm and said in a very nasty tone "what will the doctor think of your messing about and stopping the fluids, he might get dehydrated you know".

Actually bitch the doctor will have a fit if I leave all this stuff untouched for two hours until he gets here. These are nursing duties and the kinds of things that the doctors expect just to get done in this situation without him being there or having to tell me. As a matter of fact, if your dad dies (and he will if you don't get your hand off my arm and let me stop those fluids that are killing him) I will get blamed for not stopping those fluids that are overloading him and sending him into heart failure. This stuff is basic nursing, not doctoring. I don't mind questions but when they are arrogant and nasty I desire to respond in kind.

But on television these people see the doctors doing all aspects of care while the nurse merely answers the phone and "helps" the doctor. They think that is real. Their minds are warped.

I decided to put a patient with a grade 2 pressure ulcer on an airmattress. "What will the doctor think about that, isn't it his decision" said the patient's son.

Pressure area care is the last thing doctors ever ever ever want to hear about and if I EVER rang a busy doctor to ask what I should be doing about pressure area care he would scream at me and report me for dumping nursing duties on him.

But the public thinks that the doctors are the top of the food chain, in charge of everything. They are merely in charge of diagnosing illness, interpreting test results and prescribing a plan of treatment. That is different from being in charge of the whole 9 yards.

Once a care assistant forgot to leave a patient a glass for his water and the patient demanded to speak to the doctor in charge about this lapse in care.

LOL LOL LOL. Really, the doctor is more concerned about diagnosing and treating your illness. Now let me get you that water glass and remind the HCA not to miss your bed.

The public assumes they know what a doctor is. They assume they know what a nurse is.

They don't. What they don't realise is that most of their "knowledge" comes from childrens' books that show Dr. Smith doing all the treatment while Nurse Susie hands the patient a teddy bear.

Their "knowledge" comes from Grey's anatomy, House and the daily mail. They don't even realise that their minds are warped or that their opinions have been molded by inaccurate media portayals.

I saw a comment on a blog that went like this "why does a nurse need to go to university when her entire job revolves around the physical hygeine needs of the patient". This guy was serious. You just cannot believe the stupidity.

I had a patient come from a surgical ward with fast running IV fluids. He was short of breath, neck the size of a tree trunk, no urine output, no diuretics ordered. Fucking surgical ward over did it with the fluids and then sent him to us ? PE. Yeah right. Maybe, but he was obviosuly in failure. As I was waiting for the doc to call me back I stopped the fluids, put the 02 on, catheterized him, got the furosemide ready in case they ordered it. et etc. Doctors are not usually just there in an instant. They don't hang out on the wards in real life.

As I was stopping patient's drip his daughter put her hand on my arm and said in a very nasty tone "what will the doctor think of your messing about and stopping the fluids, he might get dehydrated you know".

Actually bitch the doctor will have a fit if I leave all this stuff untouched for two hours until he gets here. These are nursing duties and the kinds of things that the doctors expect just to get done in this situation without him being there or having to tell me. As a matter of fact, if your dad dies (and he will if you don't get your hand off my arm and let me stop those fluids that are killing him) I will get blamed for not stopping those fluids that are overloading him and sending him into heart failure. This stuff is basic nursing, not doctoring. I don't mind questions but when they are arrogant and nasty I desire to respond in kind.

But on television these people see the doctors doing all aspects of care while the nurse merely answers the phone and "helps" the doctor. They think that is real. Their minds are warped.

I decided to put a patient with a grade 2 pressure ulcer on an airmattress. "What will the doctor think about that, isn't it his decision" said the patient's son.

Pressure area care is the last thing doctors ever ever ever want to hear about and if I EVER rang a busy doctor to ask what I should be doing about pressure area care he would scream at me and report me for dumping nursing duties on him.

But the public thinks that the doctors are the top of the food chain, in charge of everything. They are merely in charge of diagnosing illness, interpreting test results and prescribing a plan of treatment. That is different from being in charge of the whole 9 yards.

Once a care assistant forgot to leave a patient a glass for his water and the patient demanded to speak to the doctor in charge about this lapse in care.

LOL LOL LOL. Really, the doctor is more concerned about diagnosing and treating your illness. Now let me get you that water glass and remind the HCA not to miss your bed.

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From a patients point of view, and one that has experienced several poorly trained nurses(YES NURSES) I have been yelled at ridiculed and even had treatments with held from me, because I refused to take insults and even foul comments. I blame the training faculty for teaching new nurses that they are incharge and not the patient. That is ok for them to threaten a patient, even unto physical abuse if necessary to make them do what they want to do to the patient. So in my own opinion it is the older nurses with university degrees that teach these new nurses their behavior. Compassion and caring are out the window. I have seen few nurses just paycheck collectors on duty. Unless the good nurses are willing to train the new ones in the proper care of patients it will only get worse. Aides and assistants are only as good as they are trained. Yes the hospitals are mostly to blame for the poor training because they just want someone to do the running as cheap as they can get. They rush the training to get more cheap labor on the floor. I truly feel for the good caring nurse, as they usually have to work double time to make sure things are done and done right. Patients and families of patients have to be there to make sure the patient is cared for properly.

From a patients point of view, and one that has experienced several poorly trained nurses(YES NURSES) I have been yelled at ridiculed and even had treatments with held from me, because I refused to take insults and even foul comments. I blame the training faculty for teaching new nurses that they are incharge and not the patient. That is ok for them to threaten a patient, even unto physical abuse if necessary to make them do what they want to do to the patient. So in my own opinion it is the older nurses with university degrees that teach these new nurses their behavior. Compassion and caring are out the window. I have seen few nurses just paycheck collectors on duty. Unless the good nurses are willing to train the new ones in the proper care of patients it will only get worse. Aides and assistants are only as good as they are trained. Yes the hospitals are mostly to blame for the poor training because they just want someone to do the running as cheap as they can get. They rush the training to get more cheap labor on the floor. I truly feel for the good caring nurse, as they usually have to work double time to make sure things are done and done right. Patients and families of patients have to be there to make sure the patient is cared for properly.

I'm impressed, I must say. Rarely do I come across a blog that's both educative and interesting, and without a doubt, you have hit the nail on the head.The issue is something which too few men and women are speaking intelligently about. I am very happy I came across this in my hunt for something relating to this.

Heya are using Wordpress for your blog platform?I'm new to the blog world but I'm trying to get started and set up my own. Do you require any html coding knowledge to make your own blog?Any help would be greatly appreciated!

Hello! I know this is kinda off topic however , I'd figured I'd ask.Would you be interested in trading links or maybe guest writing a blog article or vice-versa?My site goes over a lot of the same topics as yours and I believe we could greatly benefit from each other.If you happen to be interested feel free to send me an e-mail.

I have just been in hospital for a minor reason. Co-incidentally, I run a successful business with 600 staff so I know a thing or two about operational management. First and foremost, those nurses who do care, are brilliant and well worth their salaries - if not more. However, one thing which was abundantly clear was that perhaps half of the staff really had an attitude problem i.e. you're lucky we're prepared to do this for you. Second key issue for me was the lack of direction/focus. There never seemed to be anybody with any sense of authority controlling what goes on daya to day and that is a real issue which needs addressing. Top of the head, I would say Hospitals could easily lose half their admin staff, a third of nursing staff, and perform better.

In an atmosphere if universal deceit telling the truth is a revolutionary act. George Orwell.

Why has Nursing Care Deteriorated

Good nurses are failing every day to provide their patients with a decent standard of care. You want to know what has happened? Read this book and understand that similiar things have happened in the UK. Similiar causes, similiar consequences. And remember this. The failings in care have nothing to do with educated nurses or nurses who don't care. We need more well educated nurses on the wards rather than intentional short staffing by management.

About Me

I am a university educated registered nurse. We had a hell of a lot of hands on practice as well as our academic courses. The only people who say that you don't need a brain or an education to be an RN are the people who do not have any direct experience of nursing in acute care on today's wards. I have yet to meet a nurse who thinks that she is above providing basic care. I work with nurses who are completely unable to provide basic care due to ward conditions.
I have lived and worked in 3 countries and have seen more similarities than differences. I have been a qualified nurse for nearly 15 years. I never used to use foul language until working on the wards got to me. It's a mess everywhere, not just the NHS.
Hospital management is slashing the numbers of staff on the ward whilst filling us up with more patients than we can handle... patients who are increasingly frail. After an 8-14 hour shift without stopping once we have still barely scratched the surface of being able to do what we need to do for our patients.

Quotes of Interest. Education of Nurses.

Hospitals with higher proportions of baccalaureate-prepared nurses tended to have lower 30-day mortality rates. Our findings indicated that a 10% increase in the proportion of baccalaureate prepared nurses was associated with 9 fewer deaths for every 1,000 discharged patients."...Journal of advanced nursing 2007

THIS MEANS WE NEED WELL EDUCATED NURSES AT THE BEDSIDE NOT IN ADVANCED ROLES

Dr. Linda Aiken and her colleagues at the University of Pennsylvania identified a clear link between higher levels of nursing education and better patient outcomes. This extensive study found that surgical patients have a "substantial survival advantage" if treated in hospitals with higher proportions of nurses educated at the baccalaureate or higher degree level.

THIS MEANS WE NEED WELL EDUCATED NURSES AT THE BEDSIDE NOT IN ADVANCED ROLES

Dr. Linda Aiken and her colleagues at the University of Pennsylvania's Center for Health Outcomes and Policy Research found that patients experienced significantly lower mortality and failure to rescue rates in hospitals where more highly educated nurses are providing direct patient care.

Evidence shows that nursing education level is a factor in patient safety and quality of care. As cited in the report When Care Becomes a Burden released by the Milbank Memorial Fund in 2001, two separate studies conducted in 1996 - one by the state of New York and one by the state of Texas - clearly show that significantly higher levels of medication errors and procedural violations are committed by nurses prepared at the associate degree and diploma levels as compared with the baccalaureate level.

Registered Nurse Staffing Ratios

International Council of Nurses Fact Sheet:

In a given unit the optimal workload for a registered nurse was four patients. Increasing the workload to 6 resulted in patients being 14% more likely to die within 30 days of admission.

A workload of 8 patients versus 4 was associated with a 31% increase in mortality. (In the NHS RN's each have anywhere from 10-35 patients per RN. It doesn't need to be this way..Anne)

Registered Nurses in NHS hospitals usually have between 10 and 30+ patients each on general wards.

Earlier in the year, the New England Journal of Medicine published results from another study of similar genre reported by a different group of nurse researchers. In that paper, Needleman et al3 examined whether different levels of nurse staffing are related to a patient’s risk of developing complications or of dying. Data from more than 5 million medical patient discharges and more than 1.1 million surgical patient discharges from 799 hospitals in 11 different states revealed that patients receiving more care from RNs (compared to licensed practical nurses and nurses’ aides) and those receiving the most hours of care per day from RNs experienced fewer complications and lower mortality rates than those who received more of their care from licensed practical nurses and/or aides. Specifically for medical patients, those who received more hours per day of care from an RN and/or those who had a greater proportions of their care provided by RNs experienced statistically significant shorter length of stay and lower complication rates (urinary tract infections, gastrointestinal bleeding, pneumonia, cardiac arrest, or shock), as well as fewer deaths from these and other (sepsis, deep vein thrombosis) complications

•Lower levels of hospital registered nurse staffing are associated with more adverse outcomes such as Pneumonia, pressure sores and death.
•Patients have higher acuity, yet the skill levels of the nursing staff have declined as hospitals replace RN's with untrained carers.
•Higher acuity patients and the added responsibilities that come with them increase the registered nurse workload.
•Avoidable adverse outcomes such as pneumonia can raise treatment costs by up to $28,000.
•Hiring more RNs does not decrease profits. (Hospital bosses don't understand this. They think that they will save money by shedding real nurses in favour of carers and assistants. The damage done to the patients as a result of this costs more moneyi.e expensive deaths, complications,and lawsuits, and complaints....Anne)

Disclaimer

I know I swear too much. I am truly very sorry if you are offended. Please do not visit my blog if foul language upsets you. I want to help people. That is why I started this blog and that is why I became a Nurse. I won't run away from Nursing just yet. I want to stick around and make things better. I don't want the nurses caring for me when I am sick working in the same conditions that I am. Of course this is all just a figmant of my imagination anyway and I am not even in this reality. Or am I?Any opinions expressed in my posts are mine and mine alone and do not represent the viewpoint of the NHS, the RCN, God, or anyone else.